Table 1.

Community-based participatory research in primary care.

Study (year)	Approach	Community participation	Results/outcomes	CBPR benefits	Ref.
Access to care
Moreno et al. (2009)	Needs assessment	Conducted door-to-door surveys among community members for needs assessment. Held public hearings with community members to determine the concerns around and best location for a safety net medical clinic	Providers established a community health center on the campus of a local middle school through a partnership with the school district	Collaboration with community resulted in creation of a new community health center, thereby improving access to care	[21]
Kruger et al. (2010)	Surveys on health-related behaviors, attitudes and health insurance coverage	Community health surveys before, then both surveys and focus groups after expansion of the county health plan	Survey results used to gain support for the development and expansion of a county health plan that provides basic insurance for all uninsured low-income adults	Enhancement of basic insurance coverage for low-income adults in the community	[22]
Tapp et al. (2013)	Assessments of patient service areas and analysis of travel distance and cost	Provider discussion groups and patient surveys	Both patients and providers identified a culturally targeted, patient-centered medical home, with continuity of care as the ideal for receiving care	For each clinic, best practices were identified through discussion groups and surveys	[23]
Asthma
Martin et al. (2010)	Culturally tailored education modules	Community, academic and medical partners communicated at every stage of the project from conception to results dissemination	Improved asthma disease outcomes. Decreased rates of hospitalizations	Improved asthma disease outcomes. Decreased rates of hospitalizations	[26]
Moreno et al. (2009) and Bonilla et al. (2005)	Screening to identify at-risk students. Family intervention to identify environmental and social factors related to asthma	Survey given to students. Results shared with school leaders who then supported and were involved in the development of community asthma intervention	60% improvements in asthma control after 4 months	Asthma improvement among community members	[21,27]
Brenner et al. (2011, 2003)	Intervention trial to test an Integrated Pest Management program	Used existing partnership between researchers, community health centers and East Harlem (NY, USA) community members to design the research project. Together they decided to implement the pest reduction program. Community members suggested that the comparison group had to also receive an intervention of value, and injury prevention education was given to those not receiving an intervention	Decrease in cockroach infestation in low-income households	Not only improved pest management, but also gave injury prevention education to a control group	[5,28]
Levy et al. (2006)	Pest management, educational efforts, case management and support from community health advocates	Use of a decision-making committee, which included representation of all members. Included community participation during project conception, design and implementation	Significant reductions in 2-week recall respiratory symptom score and other asthma symptoms, such as wheezing and waking at night, as well as an improved asthma-related quality of life score	Improved respiratory status as a function of better pest management	[20]
Diabetes
Parikh et al. (2010)	Prediabetes prevention strategy	Created a community action board, 75% of the membership were community members. Board developed methods for interventions to improve diabetes prevention	Sustained weight loss among participants	Sustained weight loss among participants	[34]
Jackson (2009) and Mau et al. (2010)	Diabetes Prevention Program – Lifestyle Intervention	Interviews and focus groups to culturally adapt research methods	Modified intervention led to successful weight loss	Modified intervention led to successful weight loss	[35,36]
Brown et al. (2010 and 2013)	Modified diabetes prevention program to target disproportionately high Type 2 diabetes rates in an American–Indian population	Formed collaboration with local Northern Plain American–Indian communities initially to seek funding together. Then held regular meetings between academic and community members to discuss study design, recruitment and sustainability	Feasible to implement health behavior and weight loss intervention to reduce risk of Type 2 diabetes in American–Indian youths	Determined feasibility of intervention and reduced rate of BMI increase among participants	[37,38]
Obesity/exercise
Mabachi et al. (2012)	A community food assessment	Community member survey input used to tailor food access strategy	The survey results showed a desire for a grocery store in the neighborhood to improve food access and address the low frequency of fruit and vegetable consumption. The results were used to create a business plan to address the absence of healthy food access in the neighborhood	Created new food access strategy	[42]
Reininger et al. (2010)	Media campaign to reduce health risk	Community advisory boards determine the content and scope of the potential intervention. Also used focus groups to get community input on most important healthcare issues and media channels most often accessed for health information	Campaign to enhance the translation of currently recommended practices for physical activity and healthy food choices to Mexican–American individuals	Modified media campaign to improve health of specific community involved	[44]
Zoellner et al. (2012)	Community residents were surveyed to measure their physical activity, trail use and perceptions of the trails	Used community advisory board, and community members were able to participate in development, implementation and evaluation of research project. Some community members were trained to administer the surveys	Found association between trail usage and meeting physical activity recommendations. They found a need for greater invention efforts in areas of low physical activity that focus on residents’ perceptions of walking trail safety, conditions and amenities	Improved perception and usage of walking trails, which could have positive health implications for community members	[13]
Moreno et al. (2009)	Intervention to encourage daily physical activity	Initially used focus groups to determine community perceptions of walking groups. Also interviewed 200 families regarding exercise habits and views towards the walking group concept	Involved promotoras to establish a walking plan	Successfully encouraged local families to participate in walking groups, which could have positive health implications for community members	[21]
Maternal/child health
Foster et al. (2012)	Examined community perceptions of maternal and newborn health services	Based on input from Dominican nurses and midwives, the research question about pregnant women with complications was developed. Researchers trained Dominican nurses and community leaders in CBPR, who then initiated focus groups and interviews	Elucidated a general dissatisfaction with the Dominican Republic's maternal health system, with many mothers and their families feeling disrespected, ignored and afraid	The dissemination of the co-created knowledge has forged new and positive working relationships between community members and healthcare providers	[48]
Bermudez-Millan et al. (2011)	Collected community experiences and perspectives regarding stress, discrimination and stressors that affect maternal health	Several focus groups consisting of community members to identify stressors to maternal health	Found significant stressors to maternal health and child health in their community to be poverty, instability of food, lack of quality education and unsafe environments	Future interventions can address the specific stressors found in this study	[51]

CBPR: Community-based participatory research.